CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Indiana Regional Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $98
Cash Discount Price: $267
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Indiana Regional Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $267. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.78x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.

Cash / Self-Pay

$267

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)

Cash / Self-Pay: $267 (211%)

Insurance Median: $98 (78%)

Cash: $267 (211% of Medicare)

Ins. Median: $98 (78% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Highmark Wholecare	$28 - $118	22%
Highmark	$37 - $262	29%
Humana	$41 - $116	32%
Aetna	$42 - $256	33%
Medicare (plans)	$42 - $118	33%
United Mine Workers Of America	$42 - $118	33%
UnitedHealthcare	$42 - $297	33%
Ambetter / Centene	$43 - $121	34%
Amerihealth Caritas	$43 - $121	34%
Geisinger Health Plan	$43 - $121	34%
Upmc Health Plan	$58 - $713	46%
Cigna	$59 - $264	47%
Tricare	$59 - $742	47%
Geisinger	$83 - $234	66%
Pa Health And Wellness Commercial	$83 - $234	66%
Department Of Human Services And Torrance State Hospital	$467	370%
Premier Comp Solutions, Llc	$668	529%
Miscellaneous Commercial	$742	588%
Pa Workers Compensation	$742	588%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $267.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Indiana Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.